Volume 7, Issue 1, January – 2022 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

The Quality of Life in Post- Mucormycosis Patient

Rajesh K. Dase1, Vyankatesh Solanke2 , Prince3, Rajesh Kadam4 , Mrunalini Jadhav5
1
Associate Professor, Department of Community Medicine, 2Intern,
3
Junior Resident, Department of Psychiatry,
4
Associate Professor, Department of Pharmacology,
5
Intern,
MGM Medical College & Hospital, Aurangabad, [MH], India.

Abstract:- Mucormycosis (previously called zygomycosis) is a

Introduction: Mucormycosis disease very well affects the
quality of life of patient in all aspect. It affects mainly
physical health, psychological health, social relationships,
environment, sleep and rest, work capacity may be
affected. In psychological aspect bodily image and
appearance, negative feelings, self esteem, thinking and
learning are also affected.
Material & Methods: Present study was cross sectional
observational study conducted in OPD and IPD
Department of ENT & Opthalmology, MGM Medical
college & Hospital Aurngabad [MS], India diuring 1st
August 2021 to 30th September 2021.
Results: In present study we found that the incidence of
mucormycosis is more in the age group above 45 years i.e.
78(78%). Mucormycosis is mostly seen in the males more
than female i.e. 77(77%). Majority of 39(39.0%) patients
were diagnosed with mucormycosis within 30 days of
discharge and 10(10%) patients were diagnosed with
mucormycosis within 3 months of discharge. Out of 100,
96(96.0%) patients went for the operative procedure. The
mean of WHOQOL- Physical Health Domain Scores for
the patients was 42.99. The Mean WHOQOL-
Psychological Domain Scores for the patients was 46.06.
The mean Social Relationship and Environment score
were 49.62 & 58.03 respectively.
Conclusion: We concluded that there was higher impact
of Quality of Life in Post- mucormycosis patient. However
the impact was also affected by many other factors, such
as age, comorbidity, severity of illness of patients and the
impact is not reduced considerably as time goes by (i.e.
even after two months). The Quality of Life in Post-
Mucormycosis Patient in term of Physical Health and
Psychological health is most affected due to surgical
intervention and life threatening disease.
serious but rare fungal infection caused by a group of molds
called mucormycetes. These molds live throughout the
environment. Mucormycosis mainly affects people who have
health problems or take medicines that lower the body’s
ability to fight germs and sickness. It most commonly affects
the sinuses or the lungs after inhaling fungal spores from the
air. It can also occur on the skin after a cut, burn, or other type
of skin injury [2] .
Candidiasis and pulmonary aspergillosis have been
common fungal infections that were reported as super
infections in covid-19patients [3] .
On the other hand, the use of corticosteroids for
modulating immune-related lung injury and reducing the
mortality rate in the covid-19 patients, that need respiratory
supports and supplementary oxygen, may predispose the
patients to secondary infections that increase the risk of
mortality [4] .
The major risk factors for mucormycosis include
uncontrolled diabetes mellitus with ketoacidosis,
hematological malignancy, stem cell and solid organ
transplantations, Iron chelation therapy with deferoxamine,
and corticosteroid drug usage [5] .
Mucormycosis disease very well affect the quality of
life of patient in all aspect. It affects mainly physical health,
psychological health, social relationships, environment, sleep
and work capacity may be affected.
In psychological aspect bodily image and appearance,
negative feelings, self esteem, thinking and learning ability is
affected.

Keywords:- Quality of Life, Mucormycosis, COVID-19. A. Aims and Objectives:

I. INTRODUCTION  Aim:
To Assess the Quality of Life In the Post-
Covid-19 pandemic is an outbreak of coronavirus Mucormycosis Patient.
disease that was first identified in December 2019. The
severity of the disease ranges from asymptomatic infection to  Objectives:
respiratory failure and death [1] . • To record the socio-demographic profile of post
mucormycosis patients.
Secondary fungal or bacterial infections or co-infections • To assess the quality of life in the patients of
are important challenges increasing the patient’s morbidity mucormycosis.
and mortality. • To assess the change in quality of life in the
mucormycosis patients after being operated.

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Volume 7, Issue 1, January – 2022
II. MATERIAL AND METHODS
Research methodology organizes all the components of
the study in a way that is more likely to lead valid answers. It
has crucial implications for validity and credibility of the
study findings.
Research Design: The research design selected for this study
is cross sectional observational study.
Settings of the Study: It is the Physical location where study
was conducted. This study was conducted at a tertiary care
centre at MGM Medical college & hospital of Aurangabad
City.
Study Area: OPD and IPD Department of ENT &
Opthalmology, MGM Medical college & Hospital
Aurngabad [Maharashtra], India.
Data Collection: Data was collected from the Post-
Mucormycosis Patient.
International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
examined separately, Question 1 asks about individuals
overall perception of QOL and Question 2 is about overall
perception of health. Remaining 24 questions are divided in
to four domains: physical health, psychological health, social
relationships, and environmental domains. It is possible to
calculate 4 domain scores. Each domain score indicates
individual’s perception of quality of life in each particular
domain. Domains scores are then transformed to 4-20 and 0-
100 scales for to maintain uniformity. If an item is missing
from assessment mean was substituted.(7)
C. Procedure of Data Collection:
All the patients who were coming to ENT &
Ophthalmology OPD for follow up of mucormycosis and
admitted in IPD in MGM Medical College & Hospital were
approached for the participation in the study. After written
informed consent, they were assessed for inclusion &
exclusion criteria. Socio-demographic information were
noted. A patient who meets the criteria, further QOL was
assessed with the help of the WHOQOL-BREF
Questionnaire.

Period of Study: The study was conducted from 1st August
2021 to 30th September 2021.
Sampling Technique: Cases were selected using purposive
sampling.
Approval for Study: Approval for the study was obtained
from the Institutional Ethical Committee of MGM Medical
College and Hospital, Aurangabad [Maharashtra State].
D. Statistical Analysis:
The collected data was compiled in EXCEL sheet and
Master sheet was prepared. For analysis of this data SPSS
(Statistical Software for social Sciences) software version
20.0th was used. Qualitative data was represented in form
of values & percentages and Quantitative data was
represented in form of mean & SD etc.
IV. OBSERVATION & RESULTS

Sample Size: For this present study 100 cases were enrolled Table 1: Demographic profile
during study period. Demographic factor Frequency Percentage
(N=100) (%)
Inclusion Criteria: Age group 18-24 2 2.0 %
 Patient diagnosed with mucormycosis. (Years) 25-34 8 8.0 %
 Age group – 18 years and above. 35-44 12 12.0 %
 Patients who were willing to give informed consent to fill 45-54 26 26.0 %
the questionnaire. 55-65 33 33.0 %
>65 19 19.0 %
Exclusion Criteria: Gender Male 77 77.0 %
 Patients with impaired capacity to give informed consent. Female 23 23.0 %
 Patients who are already diagnosed for cancer or other life Residential Urban 48 48.0 %
threatening diseases. Background Rural 52 52.0 %
Occupation Technical 2 2.0 %
III. METHODOLOGY Clerical 2 2.0 %
Businessman 10 10.0 %
A. Assessment tools Industrial 1 1.0 %
• Demographic variables was recorded on pre-designed Skilled 23 23.0 %
Performa. Unskilled 62 62.0 %
• Performa included Name, age, sex, address, education,
Marital Married 98 98.0%
COVID status, Time of mucormycosis diagnosis, time for
Status Divorced 0 0.0%
treatment of mucormycosis will be recorded.
Widow / 2 2.0%
B. World Health Organization Quality of Life (WHOQOL) - widower
BREF: Religion Hindu 94 94.0%
This instrument is used to produce an overall quality of Muslim 5 5.0%
life profile. It contains 26 questions relating to various Christian 1 1.0%
domains of the life. Response to each question is scaled on 5 Education Primary 35 35.0%
points like scale. The first two items in this scale are Middle 5 5.0%

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Volume 7, Issue 1, January – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Higher 35 35.0% than female i.e. 77(77%). Mucormycosis have nearly equal
Secondary prevalence in rural & urban area. In occupational view the
Bachelors 24 24.0% disease was more common in the unskilled persons. The
No Formal 1 1.0% patients in the study were mostly married i.e. 98(98%). Most
Education of the patients were from the Hindu religion i.e. 94(94%).
Employment Unemployed 2 2.0% Mucormycosis was more seen in the persons who had
education more than the higher secondary school i.e. 60
Full Time 25 25.0%
(60%). The disease was more seen in the self-employed
Self 49 49.0% persons likely in agriculture field i.e. 49(49%). Most of
Employed females affected were housewife. Primary care giver of most
Housewife 20 20.0% of the patients were either spouse or husband. Most of the
Retired 4 4.0% patients suffering from mucormycosis were diagnosed with it
Primary Care Parents 68 68.0% within the 1 month of after getting discharge from COVID
Giver Siblings 32 32.0% treatment i.e. it was around 59(59%). Most of the Patients
were admitted up to 1 month for the treatment of
In present study we found that the incidence of mucormyc0sis i.e. 74(74%). In most of the patients operative
mucormycosis was more in the age group above 45 years i.e. procedures like FESS (Functional Endoscopic Sinus Surgery)
78(78%). Mucormycosis was mostly seen in the males more was done i.e around 96(96%).

Table 2 : Time Period of Diagnosis of Mucormycosis

Time Period Frequency Percentage
During Covid 15 15.0%
Within 15 Days Of Discharge 05 5.0%
Within 30 Days Of Discharge 39 39.0%
Within 45 Days Of Discharge 01 1.0%
Within 60 Days Of Discharge 30 30.0%
Within 3 Months Of Discharge 10 10.0%

Majority of 39(39.0%) patients were diagnosed with Maximum 63(63.0%) patients received treatment of
mucormycosis within 30 days of discharge and other 10(10%) mucormycosis for 30 days, whereas 21(21.0%) patients
patients were diagnosed with mucormycosis within 3 months received treatment of mucormycosis for 45 days.
of discharge.
Table 4: Details of Operative Procedure
Table 3: Duration of Treatment of Mucormycosis Operative Procedure Frequency Percent
Time Period Frequency Percentage Not Done 04 4.0%
Up To 15 Days 11 11.0% Done 96 96.0%
Up To 30 Days 63 63.0% Total 100 100%
Up To 45 Days 21 21.0% Out of 100, 96(96.0%) patients underwent operative
Up To 60 Days 05 5.0% procedure and 04(4.0%) of patients did not underwent
operative procedure.

Table 5: Mean WHOQOL-Domain Scores

Domains of QOL Number Minimum Maximum Mean Standard Deviation
Physical Health 100 20 81 42.99 9.17
Psychological 100 13 75 46.06 8.57
Social Relationship 100 25 75 49.62 9.49
Environment 100 31 75 58.03 6.76

The mean of WHOQOL- Physical Health Domain V. DISCUSSION

Scores for the patients was 42.99. The Mean WHOQOL-
Psychological Domain Scores for the patients was 46.06. The
mean Social Relationship and Environment score were 49.62
& 58.03 respectively.
In our study we found that the mean age of patient was
62.27±9.38 years that is nearly related to study of
Sandipta Mitra et al(8) they found the mean (±S.D.) age of the
patients was 57±13 year. As the patients of mucormycosis
were more common reported in above 60 years of age.

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Volume 7, Issue 1, January – 2022
In present study we found that male predominance was
more than the female that is 77%. In the other study done by
Kiran Bala they also found the similar result (9) ,
Sandipta Mitra et al also found male predominance more than
female i.e around 71%.
In present study, we found that there was nearly equal
number of patients from urban & rural area. Most of the
patients of mucormycosis in our study were unskilled by
profession i.e. 62%. This may be due to negligence towards
the health issues by them. Most of the patients in present
study were married i.e. 98%. Most of the patients were
educated more than higher secondary school i.e. 59%. Most
of the patients from this study were self employed i.e. they
are doing agriculture work etc. They were around 49%. Many
of the patients were getting primary care from their spouse or
husband i.e. around 68%.
Almost all patients in this study were tested COVID
positive in past. In a study by White et al., 26.7% of the
patients with COVID-19 were found to have invasive fungal
infection (10) . Most of the patients were diagnosed with
mucormycosis within the 30 days of getting discharge from
the hospital. In other study by Sandipta Mitra et al found that
the mean (± S.D.) time of onset of symptoms since onset of
COVID-19 symptoms was found to be 18 (± 4) days(8).
Around 74% patients received the treatment for 30 days
for mucormycosis during admission in the hospital. In present
study around 96% patients undergone surgical procedure.
Similar findings was noted by Sandipta Mitra et al (8) &
observed that 87.5% patients underwent ESS with sinus
debridement with /without orbital clearance.
The mean of WHOQOL- Physical Health Domain
Scores for the patients was 42.99. The Mean WHOQOL-
Psychological Domain Scores for the patients was 46.06. As
in mucormycosis physical health and psychological health is
mostly affected due to surgical intervention and life-
threatening disease. Also among these social relationship and
surrounding environment was affected and the mean scores
were 49.62 & 58.03 respectively.
VI. CONCLUSION
We concluded that there was higher impact of Quality
of Life in Post- mucormycosis patient. However the impact
was also affected by many other factors, such as age,
comorbidity, severity of illness of patients and the impact is
not reduced considerably as time goes by (i.e. even after two
months). The Quality of Life in Post- Mucormycosis Patient
in term of Physical Health and Psychological health is most
commonly affected due to surgical intervention and life-
threatening diseases. So for treatment of mucormycosis,
psychological counselling should be part of the treatment for
all patients to improve their quality of life. Although the long-
term impact of mucormycosis is not fully developed and
require further observation.
IJISRT22JAN436 www.ijisrt.com
International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
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